结构性耻辱和性少数群体男性抑郁和自杀:对48个国家机制和流动性的多层次检查。

IF 4.6 1区 心理学 Q1 Medicine
John E Pachankis, Mark L Hatzenbuehler, Richard Bränström, Axel J Schmidt, Rigmor C Berg, Kai Jonas, Michal Pitoňák, Sladjana Baros, Peter Weatherburn
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引用次数: 7

摘要

性少数男性比异性恋者更容易抑郁和自杀。耻辱感是造成这种差异的最常见的假设风险因素,它在社会生态层面上起作用——结构(如法律)、人际(如歧视)和个人(如自我耻辱感)。尽管关于耻辱和心理健康的文献主要集中在人际和个体形式的耻辱上,但新兴研究表明,结构性耻辱也与不良的心理健康结果有关。然而,关于结构性耻辱感的变化(例如当被耻辱感的人转移到耻辱感较低的环境时)是否会影响心理健康以及这种关联的机制的数据有限。为了解决这些问题,我们使用了2017/18年欧洲男性网络调查(n = 123,428)的数据,该数据评估了心理健康(即患者健康问卷)和心理社会中介(即性取向隐藏、内化同性恋消极情绪和社会孤立)。我们将这些数据与受访者原籍国(N = 178)和接收国(N = 48)与性取向相关的结构性耻辱的客观指标联系起来,包括15项法律和政策以及总体社会态度。在仍然生活在其出生国的受访者中(N = 106,883),结构性耻辱通过内化的同性恋消极和社会孤立与抑郁和自杀有关。在从结构污名较高的国家迁移到结构污名较低的国家的受访者中(n = 11,831),在接收国的结构污名较低的环境中暴露时间越长,其抑郁和自杀风险越低;2)较低的隐蔽性、内化同性负性和社会孤立几率;3)结构性耻感通过这些中介对心理健康的间接影响较小。这项研究提供了额外的证据,表明耻辱是心理健康的社会文化决定因素。(PsycInfo Database Record (c) 2021 APA,版权所有)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Structural stigma and sexual minority men's depression and suicidality: A multilevel examination of mechanisms and mobility across 48 countries.

Sexual minority men are at greater risk of depression and suicidality than heterosexuals. Stigma, the most frequently hypothesized risk factor for this disparity, operates across socioecological levels-structural (e.g., laws), interpersonal (e.g., discrimination), and individual (e.g., self-stigma). Although the literature on stigma and mental health has focused on interpersonal and individual forms of stigma, emerging research has shown that structural stigma is also associated with adverse mental health outcomes. However, there is limited data on whether changes in structural stigma, such as when a stigmatized person moves to a lower stigma context, affect mental health, and on the mechanisms underlying this association. To address these questions, we use data from the 2017/18 European Men-who-have-sex-with-men Internet Survey (n = 123,428), which assessed mental health (i.e., Patient Health Questionnaire) and psychosocial mediators (i.e., sexual orientation concealment, internalized homonegativity, and social isolation). We linked these data to an objective indicator of structural stigma related to sexual orientation-including 15 laws and policies as well as aggregated social attitudes-in respondents' countries of origin (N = 178) and receiving countries (N = 48). Among respondents who still live in their country of birth (N = 106,883), structural stigma was related to depression and suicidality via internalized homonegativity and social isolation. Among respondents who moved from higher-to-lower structural stigma countries (n = 11,831), longer exposure to the lower structural stigma environments of their receiving countries was associated with a significantly: 1) lower risk of depression and suicidality; 2) lower odds of concealment, internalized homonegativity, and social isolation; and 3) smaller indirect effect of structural stigma on mental health through these mediators. This study provides additional evidence that stigma is a sociocultural determinant of mental health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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期刊介绍: The Journal of Abnormal Psychology® publishes articles on basic research and theory in the broad field of abnormal behavior, its determinants, and its correlates. The following general topics fall within its area of major focus: - psychopathology—its etiology, development, symptomatology, and course; - normal processes in abnormal individuals; - pathological or atypical features of the behavior of normal persons; - experimental studies, with human or animal subjects, relating to disordered emotional behavior or pathology; - sociocultural effects on pathological processes, including the influence of gender and ethnicity; and - tests of hypotheses from psychological theories that relate to abnormal behavior.
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